上尿路梗阻手术解除前后肾功能恢复情况 及其影响因素

Recovery of Renal Function before and after Surgical Relief of Upper Urinary Tract Obstruction and Its Influencing Factors

摘要: 目的：上尿路梗阻(UUTO)通常采用手术治疗，但术后肾功能的长期变化仍需进一步研究。本研究旨在探讨上尿路梗阻继发性肾积水手术解除后肾功能的恢复情况及其影响因素。方法：本研究回顾性收集了2023年至2025年期间在青岛大学附属医院接受上尿路梗阻手术治疗的患者临床资料。根据患者术前和术后至少6个月的估算肾小球滤过率(eGFR)水平变化进行分组，随后进行统计分析，以探究潜在的影响因素。结果：我们回顾性分析了115例患者的临床资料，其中54例患者术后eGFR水平与术前相比保持不变或升高，而61例患者术后eGFR水平下降。未发现不同手术方式对结果有显著影响。我们的研究结果表明，术后即刻血清肌酐(SCr)水平升高以及术前SCr水平较低是术后eGFR下降的风险因素。结论：对于上尿路梗阻(UUTO)手术，手术方式对术后肾功能无显著影响。术后即刻SCr水平较高以及术前SCr水平较低是eGFR下降的风险因素。

Abstract: Objective: Upper urinary tract obstruction (UUTO) is often treated surgically, but the long-term changes in renal function postoperatively require further research. This paper aims to investigate the recovery of renal function and its influencing factors before and after surgical relief of hydronephrosis secondary to UUTO. Methods: This study retrospectively collected clinical data from patients who underwent UUTO surgery for obstructive hydronephrosis at the Affiliated Hospital of Qingdao University between 2023 and 2025. Patients were grouped according to changes in their estimated glomerular filtration rate (eGFR) levels before surgery and at least 6 months postoperatively. Subsequent statistical analysis was performed to investigate potential influencing factors. Results: We retrospectively analyzed the clinical data of 115 patients, among whom 54 were classified into the group with unchanged or increased postoperative eGFR compared to preoperative levels, while 61 showed a decline. No significant influence of different surgical approaches on outcomes was identified. Our findings indicate that immediate postoperative serum creatinine (SCr) levels, and lower preoperative SCr are risk factors for postoperative eGFR decline. Conclusion: For UUTO surgery, surgical approach does not significantly affect postoperative renal function. Higher immediate postoperative SCr and lower preoperative SCr are risk factors for eGFR decline.